Credit: Boston Scientific
Julie Park graduated this year from Rowan University, but she almost didn’t make it to graduation. Last January, she sprained her ankle. A week later, she flew from her South Jersey home to Thailand for vacation. Although her ankle hurt during the trip, she didn’t think it merited going to a hospital while out of the country. What she didn’t realize at the time was that such indecision could have cost her life.
“While in Thailand, I thought the increasing leg pain was due to the fact that I was favoring one leg since I was still limping from the sprained ankle,” Park said. “I actually Googled my symptoms which is usually never a good thing to do, but sure enough, WebMD® pointed directly to blood clots. I never sought treatment, though, because I figured the internet always makes things seem more extreme than they are.”
Towards the middle of the 10-day trip, Park began having back pain when she breathed deeply or laughed. This pain only lasted a few hours, though, and did not return for the remainder of the trip. Because of this, she didn’t see this as a major concern.
Soon after returning to the United States, doctors at Shore Memorial Hospital diagnosed a large blood clot in Park’s leg, known as a deep vein thrombosis (DVT), and a massive blood clot in her lungs known as pulmonary embolism (PE).
“At the time, I was still not aware of how serious the situation was,” said Park. “Honestly, the whole time while in the hospital, I was more concerned about what school work I was missing.”
She was transferred to the Hospital of the University of Pennsylvania, where a team of interventional radiologists who specialize in minimally invasive, image-guided procedures removed the blood clot.
This story is a cautionary example to everyone during this summer travel season. While DVT can affect any age group, it is more common in individuals over 40. Strong risk factors for DVT/PE include recent major surgery or trauma, cancer, and family or personal history of prior DVT/PE.
Weaker risk factors include prolonged car or air travel, obesity, pregnancy, hormone therapy (e.g. birth control pills), and varicose veins. In Julie’s case, sitting for a long time on an airline flight combined with use of birth control pills likely played a role in her developing a DVT. Also, her grandmother had a DVT, which may have raised her risk.
As blood flows through the body, arteries transport oxygenated blood from your lungs and heart to other organs throughout the body. Veins carry deoxygenated blood back from the organs and extremities to the heart. In Julie’s case, a large blood clot in her leg broke lose, moved through her veins, and lodged in her lungs causing a near fatal pulmonary embolism. According to CDC statistics, a pulmonary embolism (PE) kills nearly 100,000 Americans each year and sudden death is the first symptom in roughly 25% of people with PE.
The procedure to remove the blood clot in Julie’s leg, known as DVT thrombolysis, was performed by Deepak Sudheendra, MD, FSIR, RPVI, an assistant professor of Clinical Radiology and a national expert in the treatment of DVT and venous disease. The procedure was a success, and Julie says that despite some residual leg pain she’s 95 percent better and has resumed her normal activities, such as kayaking in the summer and skiing in the winter, and her work as an engineer.
After the procedure, Sudheendra sent Park to see Adam Cuker, MD, a hematologist and the director of the Penn Thrombosis Center, who prescribed Park anticoagulation blood thinning medications to help prevent new clots from forming.
Blood thinning medications can help prevent a clot from getting worse and moving to the lungs and help prevent new clots from forming. The blood thinning medication does not break up the clot but rather enables your body’s own clot busting mechanism to break down the clot, which is a much slower process than the quick outpatient procedure Park underwent.
The DVT thrombolysis procedure performed by Penn Interventional Radiology is used in select patients with extensive DVT to break up the clot, quickly improve symptoms, and potentially minimize the long term complications of DVT (known as post thrombotic syndrome).
People are encouraged to seek medical attention immediately if they are experiencing any of the following: pain and/or swelling in one or both legs, unusually warm or tender skin on your leg, leg discoloration, bulging leg veins, or sudden onset chest pain or shortness of breath.